What causes trich?

In men, the parasite infects the
urethra or under the foreskin of the penis if it isn't circumcised.

What are the symptoms?

Many women and most men do
not have any symptoms of trich. But when you do have symptoms, they usually
start within 1 week after you were infected.

In women, symptoms include:

Changes in your vaginal discharge. You may notice a color or
odor that isn't normal.

Vaginal itching.

Pain during urination or sex.

In men, symptoms include:

An abnormal discharge from the penis.

Irritation of the tip of the penis.

A burning feeling when you urinate.

The time from contact with the trich parasite until you
get symptoms can range from 5 to 28 days.1 This is
called the
incubation period. You can spread trich to others
during this time and until you finish the prescribed medicine. You should avoid
all sexual contact until you finish taking your medicine and the symptoms are
gone.

How is trich diagnosed?

Your doctor can tell if
you have trich by asking about your past health and doing a physical exam. He
or she may order lab tests to find the parasite that causes trich. In women,
the parasite may sometimes be found during a routine
Pap test. This test is done as part of a regular
pelvic exam.

How is it treated?

Your doctor will prescribe
medicine called metronidazole or tinidazole to treat trich. These kill the
parasite that causes the infection. The medicine is usually taken by mouth as
pills, tablets, or capsules. Medicine given in the vagina will not cure
trich.

It is important to treat trich. Treatment can:

Kill the parasite and get rid of the infection and the
symptoms.

Prevent you from spreading trich to others. Make sure that
your sex partner(s) will be treated at the same time that you get treatment so
that you don't get infected again. Avoid all sexual contact until you finish
taking the medicine and until your symptoms are gone.

Reduce the risk of pelvic infections. These may lead to women
not being able to get pregnant (infertility). Trich can also lead to
infertility in men.

How is trich spread, and how can it be prevented?

Trich is spread when a person has unprotected sex with an infected
partner. Some people carry the parasite that causes trich, but they do not have
symptoms. So it is important to practice safer sex to prevent getting trich.
Using a condom each time you have sex may reduce your chance of getting an
STI.

In rare cases, it may be possible to get trich from contact
with personal items, such as a wet towel, that a person with trich has just
used. The trich parasite cannot live on objects for long, so it isn't usually
spread this way.

Trich may be spread from a mother to her baby
during a vaginal delivery, but this is also rare.

Symptoms of a
trich infection in young children may be a sign of sexual abuse. They need to
be checked by a doctor.

In men,
infections develop in the urethra or under the foreskin of an uncircumcised
penis.

Symptoms

Up to 50 out of 100 women and men infected with
trichomoniasis (trich) do not have symptoms.2 If symptoms develop, they usually appear within 1 week after a person is infected. But symptoms can develop months later.

In women

Symptoms may be worse during pregnancy
or right before or after a menstrual period. Symptoms in women may
include:

Large amounts of pale yellow or gray-green, sometimes foamy
discharge from the vagina.

Vaginal itching or irritation.

Abnormal musty or fishy odor.

Pain with sexual intercourse even if you use a lubricant such
as K-Y Jelly or Astroglide.

Patchy red areas on the genitals or on the cervix (strawberry
cervix).

Painful urination (dysuria) or frequent urination.

Discomfort in the lower abdomen. This isn't a common symptom
of trich, and it may mean another problem is present.

In men

Men rarely have symptoms but still need
treatment. If symptoms are present, they may include:

Abnormal discharge from the penis.

A burning feeling after urination.

Irritation and redness of the tip of the penis.

Trich can have symptoms similar to those of other
sexually transmitted infections such as
gonorrhea or
chlamydia.

What Happens

Trichomoniasis
(trich) infection is spread when you have unprotected sex with an infected partner.
Many women and most men do not have any symptoms of trich. If symptoms appear,
they usually start within 1 week after a person is infected. But it may take up to a month for symptoms to appear. In most cases, trich should be treated to prevent
transmitting this sexually transmitted infection (STI) to others and to prevent some problems that can happen if
you are pregnant. You and your sex partner(s) should be treated for trich at
the same time, to avoid reinfecting each other.

Trich during pregnancy raises the risk of premature rupture of membranes
(PROM) and premature delivery. Treating the infection doesn't appear to reduce
this risk.3 If you are pregnant and have trich, talk
to your doctor about the pros and cons of treatment.

Trich may be
transmitted from a mother to her baby during a vaginal delivery, but this is
rare.

What Increases Your Risk

Those most affected by
trichomoniasis (trich) are sexually active women ages 16
to 35. It is thought that 1 out of 5
women in this age group will become infected at some time.4

Behaviors that will increase your risk of
getting trich include:

Not using condoms when having sex with a new partner or a partner
who may have been exposed to a
sexually transmitted infection (STI). It is possible for
a partner to transmit the trich
parasite without having any symptoms of the
infection.

Having many sex partners, which increases your risk of being
exposed to someone who has trich.
Teenagers and young adults are at higher risk for
getting trich and other STIs, because their sex partners often have had other
recent partners who may carry an STI.

You can get other STIs, such as
gonorrhea,
chlamydia,
HIV, and
syphilis, at the same time you get a trich infection.
If one STI is diagnosed, testing for other STIs should be done so that all
infections can be treated at the same time.

Some infections that
can be spread through sexual contact, such as the
human immunodeficiency virus (HIV) infection, are
life-threatening. Studies show that trich infection may increase the risk of
transmitting HIV infection.5 Health professionals
around the world are concerned about the increased risk of trichomoniasis and
HIV.

Find out that your sex partner has been diagnosed with or treated
for
trichomoniasis (trich).

Watchful waiting

Watchful waiting is a period of time during
which you and your doctor observe your symptoms or condition
without using medical treatment. Watchful waiting isn't appropriate if you
think you have trichomoniasis (trich). In most cases, trich should be treated
to prevent transmitting this sexually transmitted infection to others and to
prevent some problems that can happen if you are pregnant.

Note: Trich during pregnancy raises the risk of premature
rupture of membranes (PROM) and premature delivery. Treating the infection doesn't appear to reduce this risk.3 If you are pregnant
and have trich, talk to your doctor about the pros and cons of
treatment.

Who to see

Health professionals who can diagnose and treat a
trichomoniasis (trich) infection include:

Exams and Tests

Trichomoniasis
(trich) is diagnosed by using:

Your medical history, which will include questions about your
sexual history and practices.

A physical exam.

For women, this will include a visual
exam of the genitals, vagina, or cervix to detect patchy red spots that are
caused by trich. Any vaginal discharge will be assessed for color, odor, and
texture. A sample of discharge is taken for a wet mount test.

For men, this will include a visual
exam of the penis and a sample of discharge from the
urethra or a urine sample.

Tests to identify the trich organism.

The most common test for women is a
wet mount, a microscopic evaluation of fluid from the
vagina.

People can get other
sexually transmitted infections (STIs), such as
gonorrhea or
syphilis, at the same time they get a trich infection.
If one STI is diagnosed, you will likely be tested for other STIs so that all
infections can be treated at the same time.

In women, the trich
parasite may also be identified by a routine
Pap test done as part of a regular gynecologic exam.
Expert opinions vary on the accuracy of a Pap test for diagnosing trich. But if
a Pap test shows trich, your doctor will probably talk to you about treatment
or maybe other tests.

Treatment Overview

Trichomoniasis
(trich) is treated with an oral
antiprotozoal medicine, such as metronidazole or
tinidazole. The medicine is taken either as a single dose or as
multiple doses.

Your sex
partner(s) should be treated at the same time you are being treated. This increases
the cure rate and reduces the possibility of further transmission or
reinfection. Sexual intercourse should be avoided during treatment until
symptoms are gone and until partners have been treated. It is
best to avoid sex for 1 week after treatment with a single dose of
metronidazole. Male partners may not have symptoms but still need
treatment.

People who are infected with
HIV receive the same treatment for trich as those who
are HIV-negative.

Trichomoniasis in pregnant women

Trichomoniasis
during pregnancy raises the risk of
premature rupture of membranes (PROM) and premature
delivery. Treating the infection doesn't appear to reduce this risk.3 If you are pregnant and have trichomoniasis, talk to your
doctor about the pros and cons of treatment.

Vaginal
suppositories and creams aren't effective in curing
trich, but they may reduce discomfort and swelling in the genital area.

Follow-up

No follow-up is needed if symptoms go away. It is possible to
get trich again, so it is important to take measures to reduce your risk for
trich and other sexually transmitted infections (STIs).

If symptoms do not go away, you may need to take the medicine
again.

If treatment fails after this and you have not been
reinfected, further testing may be done to find out the cause of your
symptoms. It is possible to have a strain of trich that is resistant to
antiprotozoal medicines. High-dose tinidazole may be used for
metronidazole-resistant trich organisms and is as effective as metronidazole in
curing trich.5

Prevention

Take measures to reduce your risk of
becoming infected with
trichomoniasis (trich) or other
sexually transmitted infections (STIs), such as
gonorrhea,
chlamydia,
HIV, or
syphilis. You can also reduce the risk of transmitting
an STI to your sex partner(s).

Practice safer sex

Preventing an STI is easier than
treating an infection after it occurs.

Talk with your partner about STIs before beginning a sexual
relationship. Find out if he or she is at risk for an STI. Remember that it is
quite possible to be infected with an STI without knowing it. It can take up to
6 months before some STIs, such as HIV, are detected in the blood.

Be responsible.

Avoid sexual contact if you have symptoms of an STI or are
being treated for an STI.

Avoid all intimate sexual contact with anyone who has
symptoms of an STI.

Don't have more than one sex partner at a time. Your risk of
getting an STI increases if you have several sex partners at the same
time.

Male condom use

Using condoms may reduce the risk of
becoming infected with an STI. Condoms must be put on before beginning any
sexual contact. Use condoms with a new partner until you are certain he or she
does not have an STI. It is important that
you use a condom properly to prevent the risk of trich infection.

Female condom use

Even if you are using a birth
control method to prevent pregnancy, you may wish to use female condoms to reduce your
risk of getting an STI.

Home Treatment

There is no home treatment for
trichomoniasis (trich). But you can lower your chances
of getting trich or other
sexually transmitted infections (STIs) by making careful
choices about sex. For example, you can make sure to always use condoms during
sex. For more information, see the topic
Safer Sex.

Trich is not usually
transmitted by contact with objects. But avoid using objects
such as washcloths or wet towels that a person with trich may have used.

It is safe for a woman to use tampons while she has a trich infection,
but it may be uncomfortable.

Avoid douching. It does not help
relieve symptoms, and it can even make them worse.

Medications

Trichomoniasis
(trich) is usually treated with a medicine called metronidazole. The cure rate
in treating trich using metronidazole is 90% to 95%.5
Tinidazole has been shown to be this useful too.

Medicine choices

Antiprotozoals, such as metronidazole or tinidazole,
are medicines that kill the tiny
parasite that causes trich.

What to think about

Trich during pregnancy raises
the risk of premature rupture of membranes (PROM) and premature delivery.
Treating the infection doesn't appear to reduce this risk.3 If you are pregnant and have trich, talk to your doctor about
the pros and cons of treatment.

Metronidazole vaginal
suppositories or creams aren't recommended, because
oral metronidazole is much more effective. Vaginal medicines cure trich in less
than 50% of cases.5

Metronidazole vaginal
gel, which is used to treat
bacterial vaginosis, is not recommended for treatment
of trich.7

Other Places To Get Help

Organizations

American Social Health Association

Web Address:

www.ashastd.org

Centers for Disease Control and Prevention (CDC): National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (U.S.)

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